Coronary fistula to the right atrium: a challenge for the interventional cardiologist

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Background:

• Congenital coronary fistulas are uncommon cardiac anomalies often discovered incidentally.
• Treatment options include conservative management, surgical repair, or transcatheter closure, tailored to fistula morphology and clinical context.

Observation:

• A pediatric case involving a large coronary artery fistula originating from the aorta and draining into the right atrium was presented.
• The fistula was identified as an incidental finding during evaluation for another cardiac condition.

Findings:

• Successful transcatheter closure of the large coronary artery fistula was achieved using a 16 mm Amplatzer vascular plug II and a 6 mm Amplatzer duct occluder.
• The procedure resulted in complete occlusion of the abnormal communication between the aorta and the right atrium.

Implications:

• Transcatheter closure represents a viable and effective therapeutic option for complex congenital coronary fistulas in pediatric patients.
• This approach offers a minimally invasive alternative to surgery, potentially reducing patient morbidity and recovery time.